Majority of jailed women face mental issues

December 8, 2011
By Megan Sexton

(Medical Xpress) -- While University of South Carolina researcher Dana DeHart was visiting jails to interview inmates about their backgrounds, she kept seeing a woman who clearly had mental health issues, yet continued to cycle in and out of the jail.

You could tell she didnt need to be in jail, but she kept getting picked up, said DeHart, a professor in USCs College of Social Work. The jails are overburdened and they arent equipped to handle people with mental illness. They dont have the staff or the programming.

What the jails do have are large numbers of female inmates with mental health issues. Women in jails show rates of post traumatic stress disorder and substance dependence at least five times higher than women in the general population, according to preliminary findings from a national study.

The studys preliminary data from 219 women incarcerated in rural and urban jails indicate that 55 percent of the women meet criteria for lifetime PTSD, and 60 percent have histories of substance dependence. Incarcerated women also showed increased rates of serious mental illness when compared with women in the general population. Those include major depression (31 percent), bipolar disorders (16 percent), schizophrenia spectrum (5 percent), and brief psychotic disorder (13 percent).

The study is among the first to look into the mental health issues of women in jail.

There are a lot of indications that people who are incarcerated have high rates of mental health issues, but few studies have examined the prevalence of serious mental illness among women in jails. Thus far, most studies have concentrated on prison and not jail, said DeHart, one of the studys co-investigators.

Jails are typically filled with individuals who are awaiting trial, serving shorter sentences or charged with less serious offenses. Yet jail administrators have reported that inmates with mental illness are an increasing problem in local jails, where many of the same people cycle in and out repeatedly, she said.

The women interviewed for the study were in jail for a range of crimes. Drug offenses were prominent and were linked to property crimes and prostitution, which many women relied on to support their drug habits. The drugs are often described by women as methods of self-medicating to address backgrounds characterized by overwhelming trauma, loss and mental health struggles, DeHart said.

Many women also suffered from multiple illnesses, such as PTSD in conjunction with major depression or substance abuse, and require multiple forms of treatment, she said.

The jailing of people with mental health issues can lead to other problems, including jail overcrowding, increased pharmacological costs and stress for correctional personnel who may be ill-equipped to address mental illness, she said. DeHart said the research has important implications for mental-health screening at jails and for gender-responsive programming during incarceration and re-entry. Unlike prisons, the length of time women will be incarcerated in jails is often unknown, making development and delivery of extended treatments more challenging.

There are a lot of societal costs to not addressing the mental health needs of these persons in jail. With cuts in mental health budgets and soldiers returning from war, these issues are exacerbated, DeHart said.

Because there has been limited research on the topic, there is not enough data to determine what policy issues may have contributed to more women with mental health issues spending time in jail. But DeHart said it is likely that more funding for community-based and systems-based mental health services could help get these women the support that they need at an earlier stage in their lives.

With more data on the specific types of mental health issues these women face, we may be able to identify better ways to provide programming while the women are incarcerated and upon their release into communities, she said.

The multi-site study, funded by the U.S. Department of Justice, Bureau of Justice Assistance, is led by Shannon Lynch of Idaho State University, with co-investigators DeHart, Joanne Belknap of the University of Colorado, Boulder, and Bonnie Green of Georgetown University.

The study has been ongoing for about a year, with final results expected in June, DeHart said. Women ranging from 18 years old into their 60s serving time in rural and urban jails in South Carolina, Idaho, Colorado and the Washington DC-Maryland area were interviewed for the study.

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